Kornimate/medical-research-clean huggingface dataset:
duration of gnrh-analogue downregulation and pregnancy rates

Conditions: Infertility

Summary: the purpose of this study is to assess whether the probability of pregnancy is dependent on the duration of gnrh agonist downregulation in ivf cycles.

gnrh agonists have been used extensively in assisted reproduction technologies for inhibition of gonadotropin secretion from the pituitary prior to initiation of ovarian stimulation. administration of gnrh agonists results in the prevention of spontaneous lh surges, which lead to luteinization of the developing follicles, initiation of final oocyte maturation and a decrease in pregnancy rates. gnrh agonists are usually administered according to two protocols: the short and long protocol.in the long protocol, downregulation with gnrh agonists is initiated either in the middle of the secretory phase, or at the beginning of the follicular phase. stimulation of the ovaries with gonadotropins is initiated when downregulation is confirmed. administration of gonadotropins is usually started during the second or third week of treatment with gnrh agonists.the possibility of earlier initiation of the ovarian stimulation, if downregulation is confirmed at an earlier stage, has not been examined so far. the purpose of this study is to assess whether the duration of pituitary downregulation with gnrh agonists, prior to initiation of ovarian stimulation with gonadotropins, has any effect on pregnancy rate, in women undergoing ivf.

Eligibility criteria:
inclusion criteria: * age under 39 * less than 3 previous ivf cycles * bmi 18-29 * normal ultrasound of internal genital organs exclusion criteria: * polycystic ovarian syndrome * endometriosis

Keywords: infertility, downregulation, stimulation, agonists, long
transcervical myoma biopsy video

Conditions: Atypical; Myoma

Summary: to describe the fertility-sparing management of an atypical uterine myoma. step-by-step video explanation of transcervical biopsy using transabdominal ultrasound guidance, highlighting tips and tricks. patient consent was obtained for publication of the case.


Eligibility criteria:
inclusion criteria: * age \>18 years old * woman with desire for pregnancy * atypical myoma exclusion criteria: - age \< 18 years old

Keywords: young woman with desire for pregnancy atypical myoma fertility preservation biopsy
the effect of vitamin d3 therapy on vitamin d status in pregnant women with vitamin d deficient and insufficient

Conditions: Vitamin D Deficiency

Summary: this study is a randomized controlled trial which compares the effect of vitamin d3 therapy 5,000 iu daily and 50,000 iu on 25(oh)d and 1,25(oh)2d, vdbp, and 24,25(oh)2d maternal serum levels in pregnant women with vitamin d deficient and insufficient.

this is a randomized controlled trial of vitamin d therapy of 5,000 iu daily or 50,000 iu weekly during pregnancy. the study is conducted at cipto mangunkusumo national center general hospital and koja distict hospital in jakarta, indonesia from april 2021 - december 2023. all the pregnant women are screened for eligibility when they presented to the clinic for antenatal care visits and are offered enrolment if they meet the following inclusion criteria: gestational age of ≤ 14 weeks, vitamin d deficient or insufficient (25(oh)d \<30 ng/ml\], and positive fetal heart rate from ultrasound examination. participants are randomly assigned to one of two parallel intervention groups, with allocation concealment: vitamin d3 (cholecalciferol) 5,000 iu/week or 50,000 iu/week. all participants are given a standard prenatal multivitamin. a medical history, physical, and ultrasound examination are performed. participants complete a questionnaire about sunlight exposure. interventions in both groups are given for four weeks. baseline blood tests, including serum 25(oh)d, 1,25(oh)2d, vdbp, and 24,25(oh)2d are performed at recruitment. after four weeks of interventions, the maternal venous blood is collected to assess serum 25(oh)d, 1,25(oh)2d, vdbp, and 24,25(oh)2d.

Eligibility criteria:
inclusion criteria: * pregnant women with gestational age of ≤ 14 weeks * vitamin d deficient or insufficient (25(oh)d \<30 ng/ml\] * positive fetal heart rate from ultrasound examination. exclusion criteria: * multiple pregnancy * pregnancy with congenital anomaly * hyperemesis gravidarum, diarrhea * complicated medical history (hypertension, diabetes mellitus, heart, kidney, or liver disease) * use of any dietary supplement containing vitamin d prior to enrolment
effect of anatabine on elevated blood levels of c-reactive protein

Conditions: Inflammation

Summary: the investigators are studying a dietary supplement called anatabine in a lozenge form named rcp006. the main purpose of this study is to evaluate the effects of this dietary supplement on normal human inflammatory function. the investigators will see this effect in volunteers who have markers of higher levels of inflammation to begin with. the investigators anticipate that anatabine will reduce markers of inflammation. therefore the investigators are looking for volunteers with high blood levels of c-reactive protein (crp) and will monitor the blood crp levels at several time points throughout the study.

the investigators are studying a dietary supplement called anatabine which for the purposes of this study has been made into lozenges and named rcp006. anatabine, the only active ingredient of rcp006, occurs throughout the world in the human food chain. anatabine has been in the human food supply and in human use for centuries. humans are exposed to anatabine in tobacco products and common and widely consumed food crops such as potatoes, peppers, eggplants and tomatoes. the main purpose of this study is to evaluate the effects of this dietary supplement on normal human inflammatory function. compounds that are chemically similar to anatabine have been shown to reduce inflammatory responses, and laboratory studies show anti-inflammatory properties for anatabine. the investigators want to explore this further in human studies to see if anatabine can maintain normal levels of inflammatory function. the investigators will see this effect more easily if the investigators look at the effects of anatabine in volunteers who have markers of higher levels of inflammation to begin with. the investigators anticipate that anatabine will reduce markers of inflammation. to look for inflammation the investigators will test blood levels of a protein called c-reactive protein. c-reactive protein (crp) is a protein found in the blood, the levels of which rise in response to inflammation. therefore the investigators are looking for volunteers with high blood levels of crp and will monitor the blood crp levels at several timepoints throughout the study. the investigators will also collect blood samples to measure other indicators of inflammation, and to measure blood levels of anatabine.

Eligibility criteria:
inclusion criteria: * healthy adults with elevated blood levels of hscrp exclusion criteria: * pregnancy or planning pregnancy * current tobacco use * current steroid use * allergy to study product components

Keywords: crp
management of asthma patients guided by exhaled nitric oxide (eno)

Conditions: Asthma

Summary: this study is designed to show that pharmacotherapy guided by eno and clinical standard of care produces a superior outcome to trial-based therapy guided by clinical standard of care alone.

patients with persistent, moderate to severe asthma will be randomized to receive therapy guided by either eno and clinical standard of care (eno group) or clinical standard of care (control group). an eno treatment algorithm will be established for each patient in the eno group at baseline (visit 1). enrollment is estimated to be six months with a follow up period of twelve months.

Eligibility criteria:
inclusion criteria: * pre-existing diagnosis of asthma * persistent, moderate or severe asthma as classified by naepp * sub-optimally controlled asthma * initiated ics therapy for at least the past 30 days and a history of improvement of asthma control on steroids exclusion criteria: * active cigarette smoking or ≥ 10 pack-years smoking history * xolair taken in the past 6 months prior to enrollment * oral prednisone taken in the last 4 weeks prior to enrollment * cystic fibrosis, copd, ciliary dyskinesia, chest wall deformities or scoliosis * subject is currently enrolled in another investigational drug study

Keywords: asthma inflammation nitric oxide eno feno
optimizing malaria and hiv treatment in a shifting landscape in africa

Conditions: Malaria; Hiv

Summary: a longitudinal study with four parallel cohorts with each participant followed for 2 years: two cohorts in busia (high malaria transmission site) and two cohorts in kampala (low malaria transmission). each site will have a cohort of children living with hiv (clhiv) and hiv- uninfected children and will be age-matched, enrolled in parallel, and followed for two years. all children will be enrolled without malaria infection, as determined by a negative blood smear at baseline.

clhiv will be maintained on a dolutegravir (dtg) based regimen for \>2 weeks prior to enrolment to ensure steady state. all children in busia (hiv-infected and hiv-uninfected) will be enrolled and then randomized to receive either artemether- lumefantrine (al) or artesunate-amodiaquine (as-aq) for each episode of malaria which occurs over longitudinal follow-up in year one. during year 1, they will continue to receive the same antimalarial each time they are treated for uncomplicated malaria. in year two, those children randomized to the al arm will begin to receive an alternating regimen for each subsequent malaria episode (as-aq, then al, then as-aq, etc..). if local/national guidelines in uganda for malaria change during the course of the study, the treatment arms will be altered as applicable. aim 1: to what extent does dtg impact, bmi, body composition and metabolic changes? aims 2 and 3: are there critical drug-drug interactions between dtg and first line artemisinin-based combination therapies (acts)? do these changes impact hiv and malaria outcomes? what is the status of act resistance and its relationship to pk exposure? malaria case definition: uncomplicated malaria (all of the following) * fever (≥ 37.5ºc axillary) or history of fever in the previous 24 hours * positive thick blood smear (any parasitemia) * absence of severe malaria severe malaria * evidence of severe malaria as per who criteria

Eligibility criteria:
inclusion criteria: * agreement to come to the clinic for all follow-up evaluations * provision of informed consent and assent (as appropriate) * residency within approximately 30 km of the study clinic * negative blood smear for malaria (all sites) * for children and adolescents living with hiv * confirmed hiv infection * on dtg-based regimen for ≥14 days * for hiv-uninfected children - documentation of hiv-negative status by at least 1 assay exclusion criteria: * significant comorbidities such as malignancy, active tb, chronic/active hepatitis b/c, diabetes, severe acute malnutrition, mitochondrial disorders * receipt of known cyp interacting drugs at enrolment (except haart) - see list of disallowed medications * anemia defined by hemocue (hb \< 7.0) at the time of enrolment * signs of uncomplicated or severe malaria at the time of enrollment * prior intolerance to al or as-aq (for those in busia only) * pregnancy at enrolment (testing done at enrollment for all those of child-bearing age) * concurrent enrolment in another research study
preoperative nasal swabs from pediatric patients

Conditions: Staphylococcal Infections

Summary: we intend to take a nasal swab from each pediatric pre-operative patient in our out-clinic with the intention of looking for a connection between positive operative incisions and a positive nasal swab. the patients will be in the out-patient clinic for a few hours, and will be examined post-operatively after one week. those with positive nasal swabs will be advised to apply a nasal cream (mupirocin)in their noses for one week. our hypothesis is that there is a correlation between positive nasal swabs and positive incision infections.


Eligibility criteria:
inclusion criteria: * all pediatric patients attending outpatient surgery clinic exclusion criteria: * all others
enhancing diabetic foot education by viewing personal plantar pressures

Conditions: Diabetes Mellitus; Diabetic Neuropathies; Foot Complications

Summary: the purpose of this study is to examine the effectiveness of a novel patient education strategy, compared to a standard diabetic foot education. the proposed diabetic foot care education uses personal computer-animated plantar pressure data to educate patients on why and how they should care for their feet.

using block randomization, subjects with diabetes were assigned to either the standard or the enhanced education group. the effectiveness of enhanced education was evaluated as measured by foot care behavior score, patient's interpretation of neuropathy scores, and the incidence of diabetic foot complications over a course of 1-year.

Eligibility criteria:
inclusion criteria: * male or female between the ages of 21 and 75 years (inclusive) * documented type 1 or type 2 diabetes mellitus * demonstrates peripheral neuropathy (defined as vibration perception threshold (vpt) ≥ 25 volts at the hallux, as quantified by a biothesiometer, or unable to perceive a 10 gram semmes-weinstein monofilament in one four sites on the feet) * able to walk independently without the use of walking aids (cane, crutches, or walker) * able to speak and understand english * able to understand the information in the informed consent form and willing and able to sign the consent form exclusion criteria: * amputation of either foot proximal to midfoot * presence of cutaneous ulceration in the lower extremity * history of or active charcot neuroarthropathy of either foot * severe peripheral vascular disease (ie. ischemic rest pain, 2-block claudication or gangrene) * end stage kidney disease requiring hemodialysis, stroke, or widespread malignant disease * pregnant or nursing * life expectancy \< 12 months * not willing or able to make the required follow-up visits * insufficient (corrected) vision to complete the questionnaires

Keywords: diabetes mellitus diabetic foot diabetic peripheral neuropathy diabetic foot education
erythropoietin treatment in patients with systolic left ventricular dysfunction, mild anemia and normal renal function

Conditions: Heart Failure

Summary: erythropoietin treatment in patients with systolic left ventricular dysfunction, mild anemia and normal renal function


Eligibility criteria:
inclusion criteria: * ischemic heart disease * systolic lv dysfunction * mild anemia * normal renal function * stable condition exclusion criteria: * pregnancy * unstable condition * under 18 years old
pilot study,diode laser 808 nm supported direct pulp capping in permanent teeth

Conditions: Haemostatic; Bacterial De-contamination; Bio-stimulation; Reparative Dentine Formation; Pain Reduction

Summary: the purpose of this study was to compare the conventional and diode 808 nm laser-assisted techniques in direct pulp capping in permanent teeth .the present study was based on a series of ten clinical studies with pulp exposure caused by carious lesions.the hypothesis of this paper was laser supported direct pulp cap-ping has proven effectiveness by its capacity to stimulate reparative dentine formation by pulp cells, de-contamination ability of irradiated areas, its ability in the fast and better haemostatic, and pain reduction.


Eligibility criteria:
inclusion criteria: 1. permanent teeth with deep caries 2. vitality of teeth 3. no peri-apical radiographic changes 4. acceptance research program exclusion criteria: 1. symptoms 2. peri-apical radiographic changes 3. no stopped bleeding within 3 minutes after exposure 4. no acceptance study program

Keywords: pulp capping, diode laser 808 nm, tertiary dentin, rm-gic
tauroursodeoxycholic acid (tudca) in new-onset type 1 diabetes

Conditions: Type 1 Diabetes

Summary: clinically, the ability to slow or prevent beta cell demise can prevent or improve the course of type 1 diabetes. the immune-mediated destruction of beta cells that is an apparent major pathological basis for the disease, has led to efforts to prevent or suppress this immune assault. here the investigators propose to buttress the beta cell's capacity to withstand this assault by improving the function of the endoplasmic reticulum stress resolving mechanisms within these cells. the ability to do so could have a major impact on preventive and therapeutic strategies for type 1 diabetes (and possibly other types of diabetes). the type of endoplasmic reticulum stress relieving agent (tudca) proposed here could ultimately be applied on an anticipatory basis to individuals at high risk for type 1 diabetes.

reducing endoplasmic reticulum stress will promote beta cell survival in new-onset type 1 diabetes. the primary aim is to test the clinical efficacy of an already approved agent, tudca, re-purposed to reduce endoplasmic reticulum stress and improve beta cell survival in patients with new onset type 1 diabetes. the primary endpoint of this proposed double-blinded randomized placebo-controlled pilot study is c-peptide measured after mixed meal stimulation test at randomization and then at 6 and 12 months of treatment with tudca compared to treatment with placebo and at 6 months following treatment. tudca is an oral medication with a safety profile that is approved for use in europe for gall stones and liver disease. the drug and similar compounds has been used in children, as young as newborns, and in adults. tudca's ability to lower endoplasmic reticulum stress has only recently been recognized and will be applied to new-onset type 1 diabetes in this proposal. if this pilot trial is successful, future studies could include broadening the recipients to antibody-positive pre-type 1 diabetes patients and/or combining tudca with other agents shown to have a beneficial effect on insulin secretion in new-onset type 1 diabetes.

Eligibility criteria:
inclusion criteria: * type 1 diabetes according to american diabetes association criteria * diagnosis of type 1 diabetes within 100 days of randomization * one positive diabetes-related autoantibody * ages 18-45 years exclusion criteria: * drugs known to affect glucose other than insulin * stimulated c-peptide levels \< 0.2 pmol/ml measured during a mixed meal tolerance test conducted at least 21 days from diagnosis of diabetes and within one month (37 days) of randomization to either tudca or placebo. * women during pregnancy

Keywords: type 1 diabetes (t1d) endoplasmic reticulum (er) stress induced pluripotential stem (ips) cells tauroursodeoxycholic acid (tudca)
clinical usefulness of a magnifier for insulin pen

Conditions: Diabetes Mellitus

Summary: insulin treatment is crucial for glucose control. many patients with type 2 diabetes exhibit inadequate glycemic control in spite of combination of oral antidiabetic drugs and eventually need insulin therapy. patients who need insulin therapy are older and have poor visual acuity, which predispose to inaccurate dosing and consequent hyper or hypoglycemia.in this study, the investigators examined the clinical usefulness of a magnifier for elderly diabetic patients who had used insulin pens.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of diabetes mellitus * over 60 years old * who have self-injected insulin with insulin pens exclusion criteria: * who have visual acuity less than 20/200 for each eye * who had surgery on his/her eyes within a week

Keywords: insulin diabetes low vision
vitamin d and hba1c levels in diabetic patients with ckd

Conditions: Vitamin D Deficiency; Diabetes Mellitus

Summary: the purpose of this study is to determine the association between serum 25-hydroxyvitamin d and hba1c levels in diabetic patients with chronic kidney disease. the investigators hypothesized that serum 25-hydroxyvitamin d levels were negatively correlated with hba1c levels.

this was a cross sectional study using consecutive sampling methodology for participant recruitment. it was carried out at the specialized diabetic, renal, and general outpatient clinics in the university of malaya medical centre (ummc), kuala lumpur, malaysia. serum 25(oh)d levels were determined by using direct chemiluminesent immunoassay (advia centaur xp; siemens healthcare diagnostics, tarrytown, new york, usa). serum hba1c levels were determined using high-pressure liquid chromatography (variant™ ii turbo; bio-rad, hercules, california, usa). data collected will be analyzed using statistical package for social sciences spss version 23.0 for windows, version 23.0 (ibm corp., armonk, new york, usa).

Eligibility criteria:
inclusion criteria: * egfr 15-59 ml/min/1.73m2 * age ≥ 18 years old * able to provide informed consent exclusion criteria: * active infections * autoimmune diseases * malignancies * on immunosuppressive therapy * on vitamin d supplements
effect of rapamycin to improve cardiac function in frail older adults

Conditions: Heart Failure

Summary: the purpose of this research is to see if the drug rapamycin will improve the heart's ability to pump by improving your oxygen consumption.

this will be a pilot, proof-of-concept study. patients 60 years or older with invasively proven hfpef or have definite hfpef as determined by the 2 established scores and frailty (positive screen for computable phenotype), will be approached for enrollment. subjects meeting screening criteria following written informed consent will be randomized to receive rapamycin or matching placebo (study drug). efficacy outcomes will be measured at baseline and at 6 months. safety will be assessed by in person or remote video monitoring weekly for 1 month, then monthly for 5 months till the end of the study. we will also measure trough rapamycin levels (≤4ng/ml) twice-a-month for the first month and then monthly for 5 months.

Eligibility criteria:
inclusion criteria: * age ≥60 years * diagnosis of hfpef by either h2fepf score of 6-9 or hfa-peff score of 5-6, or invasively confirmed diagnosis of hfpef (resting pulmonary capillary wedge pressure ≥15mmhg or ≥25mmhg with exercise). * diagnosis of computable phenotype of frailty rests on screening questions about ability to climb two flights of stairs, activities of daily living, living environment, wearing of dentures/hearing aids, and whether the patient uses assistive devices. exclusion criteria: * reduced ejection fraction (≤50%) with or without prior history of myocardial infarction * acute coronary syndrome \<3 months * uncontrolled diabetes mellitus (hba1c\>8) * uncontrolled hypertension (\>160/100mmhg, despite 3 antihypertensive medications) * nephrotic syndrome or egfr \<30ml/min/1.73m2 * cirrhosis * hepatitis b/c positive * elevated lived enzymes (ast/alt\>3uln * prior malignancy other than basal cell carcinoma * history of ongoing, chronic or recurrent infectious disease * suspected/proven immunocompromised state * uncontrolled hyperlipidemia (fasting tg \>400 mg/dl (\>4.5 mmol/l) or total cholesterol \>300 mg/dl (\>7.8 mmol/l) despite maximum lipid lowering therapy * class iv hf symptoms